Texas State Exchange and Medicaid Expansion - Implications for Pharmaceutical Manufacturers

RELEASE DATE: October 2012  |  Pages 17

Texas represents a paradox of uncertainty built around a large uninsured population (Total = 6.2 million; 3 million Exchange premium subsidy-eligible adults and 1.9 million adult Medicaid-eligible if expansion is approved) and absolute defiance of the Affordable Care Act. With the largest uninsured population in the country, Texas is likely to see significant competition for this group once the political rhetoric subsides. The large Medicaid influx will certainly impact access and coverage of pharmaceuticals as the state's share of the Medicaid expansion costs will settle at $370-450 million per year when the state finally assumes 10% of the cost of new eligibles. 

This report has been structured for Managed Care decision makers like yourself-to assist in creating a blueprint for your organization's post-ACA market access strategies in key geographies. As key states begin to take ownership of the post-ACA access and coverage model, you will face a diverse set of market dynamics that require insight into which insurers are likely to play a prominent role in the new landscape and what the impact of their role means for access and coverage. 

Reasons to Purchase Texas: State Exchange and Medicaid Expansion - Implications for Pharmaceutical Manufacturers

Pharmspective’s assessment of the post-ACA market access landscape in Texas will help you understand:

• Opportunities and threats to market access and coverage of pharmaceuticals, based on assessment of benchmark plans

• The role of MLRs in potential Payer Exchange contracting aggressiveness among key insurers in the state

• Analysis of Medicaid Expansion including how the state may decide to leverage the potential upside from its large uninsured population with insurers

• A Situation Assessment of the post-ACA landscape for insurers in Texas including what their current competitive position across books-of-business within the state tell us about their future market prospects

Our report is a first-of-its kind analysis of the likely market dynamics that will determine how the Texas market access landscape will evolve as key ACA provisions take hold.

About Pharmspective: Pharmspective, LLC is a Specialty Therapeutics Market Research firm providing commercial insights and knowledge management applications for the biopharmaceutical industry. The company is uniquely focused on understanding the buying process for specialty therapeutics through syndicated market research studies examining clinical decision-making, drug acquisition, access and reimbursement, and therapy administration for specialty therapeutics in autoimmune diseases and Oncology. Pharmspective's Healthcare Reform team provides insights into the Affordable Care Act through its proprietary ClearView knowledge management application, market assessments of the impact of key ACA provisions on healthcare decision-makers, and its HealthCareReformInsider.com website. The company maintains offices in New York City and St. Louis, MO.  Follow Pharmspective on Twitter athttps://twitter.com/Pharmspective and follow HealthCareReformInsider.com on Twitter at https://twitter.com/HCRinsider.

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